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	<td align="center" valign="top">
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				<td align="center" valign="center"  bgcolor='#ffffff' width=240 class='normaltax' colspan=2>COMMUNITY TAX CERTIFICATE</td>
			        <td align="center" valign="center"  bgcolor='#ffffff' width=100 class='normalgray'>&nbsp;INDIVIDUAL</td>
				<td align="center" valign="center" width=180 height=20  bgcolor='#ffffff' class='ctc_item'><B>[ctc_code]</b></td>
			</tr>
			<tr>
				<td align="center" valign="top"  bgcolor='#ffffff' width=10% align=center><pre><sup class='suptitle'>YEAR</sup><BR><font class=ctc_place_issued>[FOR_YEAR]</font></pre></td>
				<td align="center" valign="top"  bgcolor='#ffffff' width=35% ><sup class='suptitle'>PLACE OF ISSUE ( City / Mun / Prov )<BR><font class=ctc_place_issued>[PLACE_ISSUED]</font></td>
				<td align="center" valign="top"  bgcolor='#ffffff' width=35% ><pre><sup class='suptitle'>DATE ISSUED</sup><BR><font class=ctc_date>[DATE]</font></pre></td>
				<td align="center" valign="top" width=20% height=20  bgcolor='#ffffff' class='normaltax'>TAX PAYER'S COPY</td>
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				<td align="center" valign="top"  bgcolor='#ffffff' width="85%" align=center colspan=3>
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					<tr>
						<td>NAME</td>
						<td>( SURNAME )</td>
						<td>( FIRST )</td>
						<td>(MIDDLE)</td></tr>
					<tr>
						<td></td>
						<td><font class=ctc_item>[ctc_last_name]</font></td>
						<td><font class=ctc_item>[ctc_first_name]</font></td>
						<td><font class=ctc_item>[ctc_middle_name]</font></td>
					</tr>
					</table>
				</td>


				<td align="" valign="top"  bgcolor='#ffffff' width=190 ><sup class='suptitle'>&nbsp;TIN IF ANY<BR>&nbsp;&nbsp;<font class=ctc_item>[ctc_tin_no]</font></td>
			</tr>
			<tr>
				<td align="" valign="top"  bgcolor='#ffffff' width="70%" align=center colspan=3>
				&nbsp;ADDRESS
				<BR>
				&nbsp;<font class=ctc_item>[ctc_address]</font>
				</td>
				<td align="" valign="top"  bgcolor='#ffffff' width=190 ><sup class='suptitle'>&nbsp;SEX<BR>&nbsp;
				<font class=ctc_item>[ctc_gender]</font>
				</td>
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	</td>
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	<td align="center" valign="top">
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				<td align="" valign="middle" bgcolor='#ffffff' class='normaltax'>CITIZENSHIP<BR>
				<font class=ctc_item>[ctc_citizenship]</font>
				</td>
			        <td align="" valign="center" bgcolor='#ffffff' class='normaltax'>ICR NO. ( If an alien )<BR><font class=ctc_item>[ctc_icr_no]</font></td>
			        <td align="" valign="center" bgcolor='#ffffff' class='normaltax'>PLACE OF BIRTH<BR><font class=ctc_item>[ctc_place_of_birth]</font></td>
			        <td align="" valign="center" bgcolor='#ffffff' class='normaltax'>HEIGHT(cm)<BR><font class=ctc_item>[ctc_height]</font></td>
			</tr>
			<tr>
				<td align="" valign="middle"  bgcolor='#ffffff' class='normaltax' colspan=2>CIVIL STATUS<BR><font class=ctc_item>[ctc_civil_status]</font></td>
			        <td align="" valign="center"  bgcolor='#ffffff' class='normaltax'>DATE OF BIRTH<BR>[BIRTHDATE]<font class=ctc_item>[ctc_birth_date]</font></td>
			        <td align="" valign="center"  bgcolor='#ffffff' class='normaltax'>WEIGHT(kg)<BR><font class=ctc_item>[ctc_weight]</font></td>
			</tr>
			<tr>
				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>PROFESSION / OCCUPATION / BUSINESS<BR>
				<font class=ctc_item>[ctc_occupation]</font>
				</td>
			        <td align="center" valign="center"  bgcolor='#ffffff' class='normaltax'>TAXABLE AMOUNT</td>
			        <td align="center" valign="center"  bgcolor='#ffffff' class='normaltax'>COMMUNITY TAX DUE</td>
			</tr>
			<tr>
				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>A. BASIC COMMUNITY TAX (Php5.00) Voluntary or Exempted (Php1.00)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_basic_tax]</font></td>
			</tr>
			<tr>
				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>B. ADDITIONAL COMMUNITY TAX ( tax not to exceed Php5,000.00) </td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'></td>
			</tr>
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				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>1  GROSS RECEIPTS OR EARNINGS DERIVED FROM BUSINESS DURING THE PRECEDING YEAR( Php1.00 for every Php1,000.00)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax1]</font></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax1_due]</font></td>
			</tr>
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				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>2  SALARIES OR GROSS RECEIPT OR EARNINGS DERIVED FROM EXERCISE OF PROFESSION OR PURSUIT OF ANY OCCUPATION (Php1.00 for every Php1,000.00)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax2]</font></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax2_due]</font></td>
			</tr>
			<tr>
				<td align="" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2>3  INCOME FROM REAL PROPERTY (Php1.00 for every Php1,000.00)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax3]</font></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_additional_tax3_due]</font></td>
			</tr>
			<tr>
				<td align="" valign="top"  bgcolor='#ffffff' class='normaltax' rowspan=4><!--Right Thumb Print--></td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax' rowspan=2>
			        <!--<BR>------------------------------------------<BR>Tax Payer's Signature<BR><BR>--></td>
			        <td align="" valign="center"  bgcolor='#ffffff' class='normaltax'>TOTAL(Php)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_total_amount_due]</font></td>
			</tr>
			<tr>


			        <td align="" valign="center"  bgcolor='#ffffff' class='normaltax'>Interest(Php)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_total_interest_due]</font></td>
			</tr>
			<tr>

			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax' rowspan=2><!--<BR>------------------------------------------<BR>Tax Payer's Signature<BR><BR>--></td>
			        <td align="" valign="center"  bgcolor='#ffffff' class='normaltax'>Total Amount Paid(Php)</td>
			        <td align="right" valign="center"  bgcolor='#ffffff' class='normaltax'><font class=ctc_item>[ctc_total_paid]</font></td>
			</tr>
			<tr>


			        <td align="center" valign="center"  bgcolor='#ffffff' class='normaltax' colspan=2><!--(in Words)--><BR></td>
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	</td>
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</table>
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